Principal Healthcare Consultant, Claims

| Chicago, IL | Hybrid
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Ready to thrive in the next step on your career journey?

West Monroe is hiring a Principal with prior industry or consulting leadership management, project delivery, and systems implementation / assessment experience with deep subject matter expertise to join our Healthcare and Life Sciences practice. Our team assists payers, providers, and pharmaceutical companies in uncovering opportunities, developing clear roadmaps, and working toward improved outcomes. We depend on our highly skilled consultants to drive growth – in our clients’ companies and in their own careers.

What will you be doing?

  • Client Delivery:
    • Communicate and report project status to C-level executives and internal West Monroe project managers including delivery progress, risks, issues, and dependencies
    • Understand underlying relevant technology platforms and business processes to be able to direct and provide thought leadership to drive system assessment, custom design, development, testing, and implementation of a Core Administrative Processing Solutions (CAPS) (such as HealthRules Payor, Facets, QNXT, Javelina, Tapestry or others)
    • Provide expertise and best practices to clients for specific functional and/or technical areas of focus related to core administrative platforms. Example focus areas include (but are not limited to):
      • Client Installation, Enrollment and Eligibility Processing
      • Premium Billing and Administrative Services Only Policy Funding
      • Benefit Configuration, Pricing, Operations Workflows,
      • Claims, Payments, Encounter, Clinical Edit Processing
      • Provider Data Management and Network Configuration
      • Platform Configuration, Coordination, Customization and Integration
    • Quickly respond to client requests for immediate issues while also being able to drive projects to completion
    • On larger engagements, be able to work across various management teams and determine inter-dependencies between the WMP project and other initiatives
    • Provide subject matter expertise across multiple, concurrent engagements, ensuring full-time delivery team can craft deliverables based on guidance provided
    • Review project deliverables for completeness and appropriateness
    • Proactively identify risks and develop mitigation plans based on past experiences
  • Practice Development:
    • Participate actively in the recruiting process for other consultants
    • Drive the development/enhancement of the core administration platform assessment and implementation methodologies and approaches for client delivery
    • Coach and manage other consultants by providing professional guidance and sharing subject matter expertise relevant to client/project scope
    • Develop next generation of subject matter experts / leaders with a specific focus on claim platform knowledge sharing
    • Refine delivery methodologies and develop delivery tools/accelerators based on subject matter expertise
  • Business Development:
    • Understand business needs and requirements and help turn those goals into concrete projects and detailed proposals
    • Create work plans, pricing estimates, and risk assessments for prospects
    • Actively build a professional network and affiliate network in the local community
    • Contribute to revenue generation and solution offerings ideas through expertise; help execute business development campaigns
    • Build credibility with existing and prospective clients during the proposal process
    • Create subject matter eminence through social media sharing, speaking engagements, industry panel participation
    • Participate in key client relationships and growing those accounts
    • Play an influencer role in the industry by providing valuable insight and thought leadership based on expertise and experience in Core Administrative Processing Solutions or in the medical claims processing industry

What do you need to bring to the table?

  • Bachelor’s degree or equivalent experience required
  • Prior industry or consulting project leadership experience
  • 10+ years of hands-on experience as a functional or technical leader driving business operation, technology projects and/or large scale software implementation projects
  • Deep subject matter expertise with three or more claims-specific systems, including but not limited to: Facets, HealthRules Payor, QNXT, Javelina, Epic Tapestry, or other CAPS
  • Knowledge and experience with complex business systems integration and technology transformation
  • Industry experience with benefit configuration, regulatory rules or claims adjudication
  • Experience working in a fast-paced, collaborative, and team-based project environment
  • Ability to lead and mentor other team members or developers while leading projects
  • Excellent leadership, organizational, verbal and written communication skills to communicate technical concepts to non-technical business stakeholders
  • Ability to travel 40-60%
  • A commitment to inclusion and diversity, and openness to new ideas and perspectives
  • Familiarity with custom design and development, database design, and data management preferred

Ready to get started? Join our team and make an impact.

At West Monroe, our people are our business.

We pride ourselves on bringing a different mindset to consulting—and that takes a different approach: highly collaborative, flexible, and tenacious.

Our people-first culture is core to our identity. It’s something we care about, and something we strive to enrich and preserve. No hierarchies. No siloes. No egos. Just smart ideas, unique perspectives, and the drive to make an impact for our clients.

We also know that the best outcomes for both our people and our clients result from including diverse perspectives at the table. That’s why inclusion & diversity is one of our core values.

Every day our clients rely on us to help them tackle their greatest challenges, by strategically deploying technology through a business-focused and industry-specific lens. We bring together both the right knowledge and the right approach, so that they can capitalize on opportunities and deliver real results. That takes the right team. And that’s where you come in.

West Monroe Partners is an Equal Employment Opportunity Employer 
We believe in treating each employee and applicant for employment fairly and with dignity. We base our employment decisions on merit, experience, and potential, without regard to race, color, national origin, sex, sexual orientation, gender identity, marital status, age, religion, disability, veteran status, or any other characteristic prohibited by federal, state or local law. To learn more about inclusion and diversity at West Monroe, visit www.westmonroe.com/inclusion.

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An Insider's view of West Monroe

How do you collaborate with other teams in the company?

West Monroe's collaborative culture allows you to grow professionally by working across practices, industries and offices - all while creating value for the client.

Kirsten

Director, Mergers & Acquisitions

What makes someone successful on your team?

If you refuse to shy away from a challenge and enjoy working with an intelligent group of people that genuinely care about those around them, your success will be imminent at West Monroe.

Adam

Senior Manager, Technology

What are West Monroe Perks + Benefits

West Monroe Benefits Overview

Choosing where to build your career is an important decision. Should you choose to build it with West Monroe, we take that commitment seriously.

We believe that when people get the support they need to thrive, they care more, do more, and achieve more. In fact, that’s our whole business strategy. So we strive to provide a total rewards model that illustrates our commitment to our people and their growth, creating value today, tomorrow, and well into the future. We invest in you through an attractive package of rewards that promotes your health and well-being, your financial future, your development, and your satisfaction and enjoyment at work.

Culture
Volunteer in local community
West Monroe encourages volunteerism both on an individual level and through coordinated volunteer opportunities, such as our Day of Service, an all-company volunteer day.
Partners with nonprofits
In 2021 West Monroe contributed more than $2,717,461 to national and local nonprofits across the country​ through corporate contributions, hands-on volunteerism, and pro bono engagements​.
Open door policy
OKR operational model
Team based strategic planning
Open office floor plan
Employee resource groups
Employee-led culture committees
Hybrid work model
Employee awards
Flexible work schedule
West Monroe offers flex schedule arrangements that allow a full-time regular employee to change the standard start and end time of their standard office hours.
Remote work program
Employees who do not live within 100 miles (or a commutable distance) to a West Monroe office are eligible to become remote employees.
Diversity
Dedicated diversity and inclusion staff
Highly diverse management team
West Monroe aims to have 25% women representation, 20% people of color representation, and 9% underrepresented people of color in leadership positions in the upcoming years.
Mandated unconscious bias training
West Monroe has unconscious bias training courses that are required for all directors and above, and open to all employees.
Diversity manifesto
Diversity employee resource groups
West Monroe has seven ERGs: Black Employee Network, Interfaith, Pan-Asian Network, SOMOS, WMPride, Veterans, and Women's Leadership Network.
Hiring practices that promote diversity
Our Talent Acquisition team is committed to an inclusive candidate experience through practices such as mitigating bias. We also work with numerous diversity recruiting partners.
Diversity recruitment program
Health Insurance & Wellness Benefits
Flexible Spending Account (FSA)
West Monroe offers employees Health Care FSAs, Dependent Care FSAs, and Commuter FSAs to help cover medical, dependent care, and commuter expenses with pre-tax contributions.
Disability insurance
If employees become ill or suffer an injury that prevents them from working, West Monroe provides short- and long-term disability insurance to replace a portion of an employee’s income.
Dental insurance
West Monroe dental insurance is provided by Delta Dental via PPO. The plan covers 100% of the cost of preventative care, including x-rays, annual cleanings, and more.
Vision insurance
West Monroe’s vision insurance is provided by VSP. The plan includes treatment for eye pain, tests to diagnose vision changes, exams to monitor cataracts, retinal screenings, and routine eye care.
Health insurance
West Monroe’s medical insurance is provided by BCBS of Illinois and Kaiser Permanente for CA & HI employees. There are two plan offerings through BCBS: PPO and a High Deductible Plan with an HSA.
Life insurance
West Monroe offers all full-time employees a $50,000 Life and AD&D policy at no cost to the employee. Employees are offered voluntary life insurance in the amount of up to $500K or 5x their salary.
Pet insurance
Employees have the ability to purchase pet insurance directly with Spot, ASPCA, or Pets Best through the West Monroe partnership with Benefit Hub.
Wellness programs
West Monroe provides many wellness benefits including gym discounts, dedicated wellness platform rewarding employees for meeting goals, and employee groups such as running club, cycling club and more.
Mental health benefits
West Monroe provides mental health benefits including access to Headspace, listening sessions on mental health topics, flexible work arrangements, employer-sponsored EAP, and a wellness committee.
Financial & Retirement
401(K)
West Monroe’s 401(k) plan is administered by Principal with options for both a Traditional or Roth account. Employer contribution match is up to 25% with a broad selection of funds to select.
401(K) matching
West Monroe’s 401(k) retirement plan matches 25% of an employee’s contribution. Both Traditional and Roth accounts are eligible to be matched.
Company equity
Employee stock purchase plan
Employees have an annual opportunity to purchase company shares through an internal marketplace within the 401(k) plan. We believe the ability of our people to invest in the future of the firm.
Performance bonus
The bonus program is tied to both firm and individual performance, as a result, an employee’s individual bonus attained may range between 0% -150% of the average.
Charitable contribution matching
West Monroe matches charitable gifts that employees make to eligible nonprofit, in addition to other charitable donations.
Child Care & Parental Leave Benefits
Childcare benefits
We partner with Bright Horizons Back-Up Care offering adaptive, flexible support for employees’ child and dependent care needs, including accessing last-minute care.
Generous parental leave
West Monroe offers 10 weeks of paid leave for all employees. Employees can combine parental leave, flexible time off, flexible scheduling, and unpaid time off.
Family medical leave
West Monroe employees are eligible for up to 12 work weeks of unpaid leave under the Family and Medical Leave Act during a rolling 12-month period.
Company sponsored family events
West Monroe's Chief Family Event Program offers sponsored family events for those interested, such as Camp West Monroe, a day at camp with an array of family activities.
Fertility benefits
West Monroe's medical plans include coverage for fertility treatment.
Vacation & Time Off Benefits
Unlimited vacation policy
Paid volunteer time
Every year, our employees come together to spend a workday supporting nonprofits in their communities through virtual or in-person volunteerism.
Sabbatical
The Fischer Global Service Fellowship Program allows employees to take a three to six-month sabbatical leave to support a philanthropic and humanitarian issue of interest anywhere in the world
Paid holidays
Paid sick days
West Monroe has a flexible time off policy which means you can use this time as paid sick days.
Office Perks
Commuter benefits
West Monroe offers a commuter flexible spending account for parking and public transit.
Company-sponsored outings
West Monore holds many company outings throughout the year including quarterly office offsite outings, and Chief Events.
Free snacks and drinks
All West Monroe office kitchens are continuously stocked with snacks and beverages for employees.
Some meals provided
There is always a lot going on at West Monroe offices. From Chief events to quarterly office meetings, there is food for employees.
Company-sponsored happy hours
Every month, West Monroe offices hold a happy hour for employees called "4 O'Clock Rocks"
Recreational clubs
Our Chiefs Program allows employees to create a CXO (Chief “Something” Officer) role outside their daily client services roles, such as Chief Outdoor Officer or Chief Snack Officer.
Fitness stipend
West Monroe partners with local gyms in New York and Chicago to provide a discounted membership. Blue Cross Blue Shield offers unlimited access to a nationwide network of gyms
Home-office stipend for remote employees
All employees receive a $75 monthly hybrid work stipend to offset specific costs associated with hybrid working.
Professional Development Benefits
Job training & conferences
West Monroe offers an internal peer training program, job training, technology insights, client case studies, and personal enrichment topics.
Lunch and learns
West Monroe's employee resource groups frequently on employee listening sessions during lunch hours to discuss important topics such as racial equity and work/life balance.
Promote from within
Mentorship program
West Monroe does not have a formal mentorship program. However, some informal programs are offered by ERGs, such as the Women's Leadership Network.
Online course subscriptions available
Paid industry certifications
West Monroe offers industry certifications that help employees grow in their expertise and career goals.

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